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- Title
Time-dependent benefit of initial thrombosuction on myocardial reperfusion in primary percutaneous coronary intervention.
- Authors
Chao, C.-L.; Hung, C.-S.; Lin, Y.-H.; Lin, M.-S.; Lin, L.-C.; Ho, Y.-L.; Liu, C.-P.; Chiang, C.-H.; Kao, H.-L.
- Abstract
Background: In ST-segment elevation acute myocardial infarction (STEMI), dislodgement of thrombus within the culprit artery during primary percutaneous coronary intervention (PCI) may cause distal embolisation and impaired myocardial reperfusion. Clinical results of thromboembolic protection strategies have been controversial. We conducted this study to investigate whether the benefit of thrombus removal is time dependent. Methods: Seventy-four STEMI patients within 12 h from onset were randomised to receive either primary PCI with initial thrombosuction (IT) or standard strategy. Results were analysed in subgroups according to the onset-to-lab time intervals (subgroup 1: 0–240 min, subgroup 2: 241–480 min and subgroup 3: 481–720 min). Results: The primary end-points were improvements in thrombolysis in myocardial infarction flow (ΔTIMI) and myocardial blush grade (ΔMBG) postprocedure. Better ΔTIMI (2.2 ± 1.1 vs. 1.5 ± 1.3, p = 0.014) and ΔMBG (2.3 ± 1.1 vs. 1.0 ± 1.5, p < 0.001) were observed in IT patients, compared with standard PCI patients. In onset-to-lab time subgroup analysis, the difference between IT and standard PCI is significant only in subgroup 2 (ΔTIMI 2.6 ± 1.0 vs. 1.3 ± 1.2, p = 0.007; ΔMBG 2.6 ± 0.9 vs. 1.0 ± 1.1, p = 0.010), but not in the other two subgroups. Conclusions: This prospective randomised study shows that primary PCI with IT may improve epicardial flow and myocardial reperfusion in patients with STEMI, and this benefit is the most significant in patients treated within 4–8 h after symptom onset.
- Publication
International Journal of Clinical Practice, 2008, Vol 62, Issue 4, p555
- ISSN
1368-5031
- Publication type
Article
- DOI
10.1111/j.1742-1241.2007.01542.x